SHARPS SAFETY: Understanding the federal needlestick prevention law, Part I

On November 6, 2000, President Clinton signed groundbreaking legislation designed to protect 8 million U.S. healthcare workers from injuries caused by needles and other sharp medical devices. The Needlestick Safety and Prevention Act (H.R. 5178) is the culmination of years of determined advocacy by healthcare workers, unions, researchers and the medical device industry, and was unanimously passed by both houses of Congress in October 2000.

Clinton's comments upon signing the Needlestick Safety and Prevention Act into law well summarize the impact of the legislation:

"Today I am pleased to sign into law H.R. 5178, the Needlestick Safety and Prevention Act. This legislation requires changes in the bloodborne pathogens standard in effect under the Occupational Safety and Health Act of 1970. Supported by healthcare workers and their unions, as well as a bipartisan group of members of Congress, this bill will help to ensure the safety of healthcare workers who may be exposed to disease while handling certain medical devices. The Needlestick Safety Act makes clearer the responsibility of employers to lessen the risk of injuries to workers from contaminated sharp devices. It also encourages manufacturers of medical sharps to increase the number of safer devices in the market. This legislation will help to make healthcare occupations safer."

Healthcare workers, industry representatives, and government leaders have also greeted passage of this important legislation with high praise. OSHA director Charles Jeffress, who has been supportive of efforts to reduce needlestick injuries through the use of safety engineered sharp devices, commented, "We will never know those whom we have helped, and they will never know us, but this mission is enormously satisfying and critically important…I am glad to have been able to help in this cause."

Janine Jagger of the International Health Care Worker Safety Center pointed to the international implications of the bill: "The Needlestick Safety and Prevention Act provides the most significant level of occupational protection afforded to any healthcare worker in the world. It is certain that many countries will follow our lead and step up their own exposure prevention efforts."

Three facets
The Needlestick Safety and Prevention Act codifies and strengthens federal OSHA's Bloodborne Pathogens Standard in three major ways:

1. H.R. 5178 requires employers to use effective engineering controls, including safer medical devices, to reduce the risk of injury from needlesticks and other sharp medical instruments. Both sharps with engineered sharps injury protections and needleless systems are added to the definitions in the OSHA standard.

2. The law requires employers to keep a record of injuries from contaminated sharps in a sharps injury log. The injury log must include detailed information on the injury, including the type and brand of device involved in the incident, the department or work area where the exposure incident occurred, and an explanation of how the incident occurred. The confidentiality of the injured employee must be protected in this record- keeping process.

3. Employers are required to involve frontline healthcare workers (non-managerial employees directly responsible for patient care who could be exposed to needlestick injuries from contaminated sharps) in the identification, evaluation and selection of safe needle devices. Joint labor-management health and safety committees such as those already required by the Joint Commission on Accreditation of Healthcare Organizations are appropriate vehicles for involving nurses in product evaluation and selection.

The implementation and effect of this new legislation depends, however, on the OSHA structure of the state in which you live. I'll discuss that in my next column.

Send questions or comments to Lisa at lisa.rn@att.net. Please also visit her website dedicated to needlestick injury prevention at www.needlestick.net.